2of3A slide and other facilities remain on the scene after the shootings at the Gilroy Garlic Featival.Photo: Noah Berger / Associated Press

3of3Unidentified women hug at Gavilan College - Gilroy Campus, the site of a reunification area, after a shooting during the Gilroy Garlic Festival on July 28, 2019 in Gilroy, CA.Photo: Cody Glenn / Special to the Chronicle

Before the first shots were fired, dozens of nurses, doctors and paramedics were already at the Gilroy Garlic Festival. Like so many others in the close-knit community, they were volunteering, helping friends in vendor booths, or just spending a Sunday afternoon with their families at the popular local event.

The shooting lasted only a minute. In that time, 16 people were hit, and the peaceful festival grounds turned into a bloody triage unit. Off-duty nurses and doctors from the local St. Louise Regional Hospital, a sponsor of the event, were on their knees applying tourniquets and pressing bandages into wounds. Paramedics were recruiting bystanders to help with CPR.

It was the kind of mass-casualty event that many of the health care providers had trained for, learning and practicing techniques to control bleeding caused by powerful semiautomatic weapons. The training often seems abstract when it’s taking place in classrooms and lecture halls, said trauma experts: Even frontline health care workers don’t expect a mass shooting to happen on their own turf.

But in Gilroy, the lessons learned from earlier shootings across the country almost certainly saved lives and improved the long-term outlook for those who survived, say local doctors and other health care providers.

“We’ve used lessons we’ve learned from military physicians as well as shootings that have happened around the country. All of those tools allow us to stop bleeding and ensure patients get to care in relatively decent condition, with wounds that are treatable,” said Dr. Adella Garland, trauma medical director at Santa Clara Valley Medical Center, which treated several shooting victims from the Garlic Festival. “It really made a big difference for us.”

The July 28 Gilroy shootings, which left three people dead, led off a week of horrific violence across the country. The following Saturday, 22 people were killed by a shooter in El Paso, Texas. Later that night, nine people were shot to death outside a bar in Dayton, Ohio.

About a dozen on-duty health care providers were already at the Garlic Festival when the shooting began, as part of the normal first-aid arrangements for an event that size. The festival is a hugely popular annual celebration, attracting roughly 100,000 visitors over a three-day period. Typically, first aid is for people suffering from heat-related injuries or twisted ankles, or in the worst case, a heart attack or stroke.

Armed police patrol the scene of the shootings during the Gilroy Garlic Festival at Chistmas Hill Park.

Photo: Cody Glenn / Special to the Chronicle

But just in case, the first-aid providers in Gilroy also carried kits designed specifically for treating gunshot wounds or other injuries involving excessive blood loss. The kits include easy-to-apply tourniquets, special gauze that can be packed into wounds to slow bleeding and plastic gloves.

The kits, and the training to use them, come from a national program called Stop the Bleed, which was developed after the massacre at Sandy Hook Elementary School in 2012. Investigators determined after the fact that at least one person may have survived if aggressive techniques to control bleeding had been applied.

The program has been fully operational for about two years. As of the end of 2018, nearly 850,000 people had been trained and nearly 20,000 kits had been distributed, according to Stop the Bleed organizers. More than 57,000 people have been trained in California.

Stop the Bleed is open to anyone — it’s been taught at high schools and Rotary Clubs — but it’s mostly to train health care professionals. It was reassuring, Garland said, to see the frontline health care providers apply those skills in Gilroy.

“They used all of the things that have been touted about controlling bleeding. They deployed perfectly,” Garland said.

The on-duty providers were joined in treating the first wave of victims by perhaps a dozen more health care workers who happened to be at the festival. Some rode along with victims in private cars to the hospital before the ambulances had arrived. A nurse at the event called the St. Louise emergency room directly to tell her colleagues to start preparing for the wounded, said Dr. Peter Coelho, medical director of the hospital.

“This is your worst nightmare event to happen in your community,” Coelho said. “On the flip side, it went better than I could have imagined. It could have been a hundred times worse.”

Michael Cabano, a duty chief with Santa Clara County Emergency Medical Services, said that in Gilroy “you essentially had neighbors helping neighbors.”

Like many of his colleagues in the area’s hospitals and emergency services, Cabano has lived in Santa Clara County most of his life. That kind of attachment to the community can make his job easier — he’s worked with some of the other emergency providers for so long that they can communicate almost without words — but it can be distressing in a disaster that hits so close to home.

Cabano was in San Jose when he got the call to Gilroy. On the 30-minute drive down, he contacted the fire division chief on site and they agreed to double the number of ambulances requested — from three to six — and to request a mobile disaster response truck with enough medical supplies to treat up to 150 people.

“My first thought was for the responders on scene providing care, making sure that they were safe,” Cabano said. Though the Gilroy gunman was confronted by police and killed himself within a minute of firing his first shot, there had been reports of a second shooter. Investigators have since determined that the gunman was almost certainly acting alone.

Mass shootings no longer seem like the kind of thing that happens in some other town, Cabano said. He’s responded to three shootings with multiple victims in Santa Clara County over just the past couple of months: the Garlic Festival; a quadruple killing in San Jose in June; and two days later, an incident in which a man shot and killed two people at a car dealership in Morgan Hill before killing himself.

“Over the last few years, we’ve seen public safety evolve so much,” Cabano said. “We never thought our reality would be responding to active-shooter incidents or these types of large-scale events. Now it’s not if, but when it happens.”

Erin Allday is a health reporter who writes about infectious diseases, stem cells, neuroscience and consumer health topics like fitness and nutrition. She’s been on the health beat since 2006 (minus a nine-month stint covering Mayor Gavin Newsom). Before joining The Chronicle, Erin worked at newspapers all over the Bay Area and covered a little of everything, including business and technology, city government, and education. She was part of a reporting team that won a Polk Award for regional reporting in 2005, for a series of stories on outsourcing jobs from Santa Rosa to Penang, Malaysia. Erin started her journalism career at the Daily Californian student newspaper and many years later still calls Berkeley her home.